MEDICARE: JEFFREY BEN WOOD MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207X00000X	Orthopaedic Surgery Physician	J6820	TX
2	207XS0117X	Orthopaedic Surgery of the Spine Physician	J6820	TX

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
4	P01055728	OTHER	TX	RR MEDICARE
6	P00663449	OTHER	TX	MEDICARE RAILROAD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
8	8BP170	OTHER	TX	BLUE CROSS BLUE SHIELD
9	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
10	610119705	OTHER	TX	US DEPT OF LABOR
11	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1356339832
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEFFREY BEN WOOD MD

Provider Business Mailing Address
First Line	:	16811 SOUTHWEST FWY
Second Line	:
City	:	SUGAR LAND
State	:	TX
Zip	:	77479-4728
Country	:	US
Telephone Number	:	281-690-4678
Fax Number	:

Provider Business Practice Location Address
First Line	:	16811 SOUTHWEST FWY
Second Line	:
City	:	SUGAR LAND
State	:	TX
Zip	:	77479-4728
Country	:	US
Telephone Number	:	281-690-4678
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/10/2005
Last Update Date	:	08/30/2016

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